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Other Systems > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Inflammatory phase 1-10 days

A

Platelet activation and clotting cascade
Necrotic tissue/bacteria removed by mast cells, neutrophil, and leukocyte so

These processes establish a clean wound bed for permanent repair processes to begin

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2
Q

Proliferation phase 3-21 days

A

Formation of new tissue signals the beginning of the proliferative phase
Keratinocytes, endothelial cells, and fibroblasts are active and the collagen matrix is formed
Wound is closed via epithelial inaction and wound contracture

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3
Q

Maturation phase 7 days to 2 years

A

Initiated when granualation tissue and epithelial differentiation begins to appear in the wound bed

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4
Q

Immature scar

A

Will appear red, raised, and rigid

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5
Q

Mature scar

A

Appear pale, flat, and pliable

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6
Q

Healing that occurs in tissues with minimal tissue loss and smooth clean edges

A

Primary intention eg surgical incision, laceration, puncture, and superficial and partial thickness wounds

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7
Q

Wounds that are permitted to close on their own with characteristics such as necrosis, irregular margins, infection, require wound care

A

Secondary intention eg neuropathic, arterial, venous, or arterial, most full thickness wounds,chronically inflamed wounds

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8
Q

Healing that is delayed primary intention healing. When wounds are at risk for developing complications for instance sepsis or dehiscence, may be temporarily left open until until risk factors are alleviated. Once that occurs primary intention can occur

A

Tertiary intention

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9
Q

A serious wound resulting from tension that causes skin to become detached from underlying structures

A

Avulsion

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10
Q

A wound that can result from shear, tension, or high force compression

A

Laceration

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11
Q

Can result from A sharp pointed object as it penetrates the skin and underlying tissues

A

Puncture

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12
Q

A wound that enters the interior of an organ or cavity

A

Penetrating

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13
Q

Proper monofilament testing procedure

A

Applied perpendicular to the skin and held in place for one second with enough force to bend the monofilament into a c shape

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14
Q

Failure to Perceive the application of 10 g monofilament

A

Indicates a loss of protective sensation and places a patient at increased risk for developing a neuropathic ulcer

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15
Q

Failure to perceive a 75 g monofilament

A

Indicates that the area is insensate

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16
Q

Venous insufficiency ulcers recommendation

A

Compression to control edema, elevate legs above the heart when resting or sleeping, attempt active exercise including frequent range of motion

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17
Q

Arterial insufficiency ulcers

A

Avoid unnecessary leg elevation, avoid using heating pad or soaking feet in hot water

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18
Q

Pressure ulcer recommendations

A

Reposition every two hours, management of access moisture, offloading will pressure relieving the voices, limit sheer traction and friction force is over fragile skin

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19
Q

What is the most common location for Venus insufficiency ulcers?

A

Proximal to medial malleolus

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20
Q

Ulcers that are smooth edged, well defined, and deep

A

Arterial insufficiency

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21
Q

Ulcers that are irregular shaped and shallow

A

Venous insufficiency ulcers

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22
Q

Ulcers what a well-defined oval shape. They also have a callused rim,cracked periwound tissue, little to no wound bed necrosis with good granulation

A

Neuropathic ulcers

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23
Q

Minimal exudate

A

Arterial

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24
Q

Heavy exudate

A

Venous

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25
Q

Low/mod exudate

A

Neuropathic

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26
Q

Full thickness tissue loss with exposed bone tendon or muscle

A

Stage iv

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27
Q

What to do with stable eschatology on the heels ?

A

Serves as the body’s natural biological cover and shouldn’t be removed

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28
Q

An exudate which is clear, light color and a thin watery consistency

A

Serous

Normal in inflammatory and proliferative healing phases

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29
Q

Exudate with a thin , red appearance due to presence of blood

A

Sanguineous

Indicative of new blood vessel growth or the disruption of blood vessels

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30
Q

Exudate that is Light red or pink with thin watery consistency.

A

Serosanguineous

Consider normal in inflammatory and proliferative phases of healing

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31
Q

Exudate presents as cloudy with a hint of yellow, thin watery, and is an early sign of infection

A

Seropurulent

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32
Q

Exudate with a yellow or green color and is think / viscous consistency and indicates infection

A

Purulent

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33
Q

Necrotic tissue type that refers to death and decay of tissue resulting from interruption in blood flow to an area of the body.

A

Gangrene

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34
Q

Types of selective debridement

A

Sharp, enzymatic, autolytic

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35
Q

What type of debridement is used for removing devitalized tissue, large amounts of thick, adherent, necrotic tissue. May also be used in the presence of cellulitis and sepsis.

A

Sharp debridement

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36
Q

What type of debridement may be used for wounds that have not responded to autolytic debridement?

A

Enzymatic - need to stop as soon as devitalized tissue is removed to avoid damage to healthy tissue

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37
Q

Autolytic debridement include the use of what 4 techniques?

A

Transparent films, hydrocolloids, hydrogels and alginates

Establish a moist environment that rehydrates necrotic tissue and Eschar, facilitating enzymatic digestion of the nonviable tissue

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38
Q

T/F Autolytic debridement should not be performed on infected wounds

A

T

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39
Q

What kind of debridement should be used on wounds with moderate amounts of exudate and necrotic tissues

A

Wet-to-dry

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40
Q

Cons of wet-to-dry

A

Painful cuz can remove granulation tissue with necrotic tissue

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41
Q

Pulsatile lavage is an example of what type of debridement that uses pressurized stream of fluid to remove necrotic tissue

A

Wound irrigation

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42
Q

Which type of debridement is more desirable for wounds that are infected or have loose debris?

A

Wound irrigation

43
Q

This type of debridement softens and loosens adherent necrotic tissue but can also cause viable tissue macerarion, edema from dependent le positioning, and systemic effects such as hypotension?

A

Hydrotherapy aka whirlpool

44
Q

Which modality is non invasive uses a sterile foam dressing which is placed in the wound and sealed with an air tight secondary dressing which attaches via tubing to a vacuum pump with a reservoir container

A

Negative pressure wound therapy

45
Q

What are the indications for growth factors?

A

Neuropathic ulcers extending into or through subcutaneous tissue with adequate circulation to sustain wound healing

46
Q

What kind of ultrasound has been shown to enhance all phases of wound healing by enhancing strength and elasticity of scar tissue?

A

Therapeutic ultrasound applied at a low intensity with pulsed duty cycle

47
Q

What kind of electrical stim has been shown to stimulate angiogenesis and epithelial migration, decrease bacterial activity and wound pain, and increase oxygen perfusion and tensile strength?

A

High-volt pulsed current estim

Monophasic direct current

48
Q

What type of dressing are useful for partial and full thickness wounds and can be used effectively with granular or necrotic wounds

A

Hydrocolloids

49
Q

What kind of dressing enables autolytic debridement and cannot be used on infected wounds?

A

Hydrocolloids

50
Q

What dressings are moisture retentive and commonly used on superficial and partial-thickness wounds that have minimal drainage ?

A

Hydrogels

51
Q

What dressing are compromised of a hydrophilic polyurethane base that contacts the wound surface and a hydrophobic outer layer?

A

Foam

52
Q

What dressing are permeable to vapor and oxygen but are largely impermeable to bacteria and water?

A

Transparent film- minimal draining wounds

Allows visualization , resistance to shearing, enables autolytic debridement, and can’t be used on infected wounds

53
Q

What dressings are highly permeable, have a tendency to adhere to the wound bed traumatizing viable tissue, and can be used for infected and non infected wounds?

A

Gauze

54
Q

What should be applied during peroneal cleansing in pt with inconsistency because of its ph balancing component?

A

Skin cleansers

55
Q

The dehydration of a wound due to poor dressing selection?

A

Desiccation

56
Q

Skin peeling or spreading

A

Desquamation

57
Q

Bruising

A

Ecchymosis

58
Q

Tissue that Readily tears, fragments or bleeds when gently palpated or manipulated

A

Friable

59
Q

Abnormal scar typically raised, red, and firm with disorganized colleges fibers?

A

Hypertrophic scar

-Keloids- exceeds the boundaries of the original wound

60
Q

A burn that typically has an entrance and an exit wound. Some complications include, cardiac arrhythmias, respiratory arrest, renal failure, neuro damage, and fracture

A

Electrical burns

61
Q

Extremely painful and blistering burn involving the epidermis and the upper portion of the dermis

A

Superficial partial thickness burn

62
Q

Burn involving complete destruction of the epidermis, dermis, and part of the subcutaneous fat layer. Minimal pain, require grafts

A

Full thickness burn

63
Q

Chemical burns from iontophoresis will occur if pH levels are ?.

A

below 3 or greater than 5

64
Q

What 3 factors contribute to burns from iontophoresis?

A

Excessive current, prolonged duration, electrode placement over defective skin areas with lower resistance

65
Q

Rule of 9s- anterior trunk

A

18%

66
Q

Bilateral Posterior LE

A

18%

67
Q

Bilateral anterior UE

A

9%

68
Q

Anticipated deformities based on burn location- anterior neck

A

Flexion possible LF- soft collar, philly collar

69
Q

Anticipated deformities based on burn location- anterior chest and axilla

A

Shoulder adduction, ext, and IR- shoulder abduction brace, airplane brace

70
Q

Anticipated deformities based on burn location- elbow

A

Flexion and pronation- gutter splint, air splint, three point splint

71
Q

Anticipated deformities based on burn location- hand and wrist

A

Ext/hyperextension of mcp joints
Flexion of the ip joints
Adduction and flexion of thumb
Flexion of wrist

72
Q

Anticipated deformities based on burn location- hip

A

Flexion and adduction- anterior hip spica , abduction splint

73
Q

Anticipated deformities based on burn location- knee

A

Flexion- conforming splint, three point splint, air splint

74
Q

Anticipated deformities based on burn location- ankle

A

Pf- posterior foot drop splint, ankle confirming splint

75
Q

For scars that take longer than 14 days to heal, the use of compression garments is beneficial if they provide how much force?

A

15-35 mm Hg is believed to create an environment that facilitates the balance of collagen synthesis and lysis, improving scar structure.

Initiate pressure 2 weeks-2months after wound closure

76
Q

Recommended parameters for desensitization interventions

A

5-10 mins , 3-4 times per day, start with slightly irritating sensation and progress to more noxious stimuli

77
Q

A temporary skin graft taken from another human, usually a cadaver, in order to cover a large burned area?

A

Allograft

78
Q

A permanent skin graft taken from a donor site on the patient’s own body

A

Autograft

79
Q

Benefits of escharotomy

A

Reduce his tension on a surrounding structure, relieves pressure from the interstitial edema, and subsequently enhances circulation

80
Q

A skin graft that contains the epidermis and dermis

A

Full thickness graft

81
Q

A temporary graft take it from another species

A

Heterograft

82
Q

A skin graft that is transferred directly from the unburned donor site to be prepared recipient site

A

Sheet graft

83
Q

A skin graft that contains only a superficial layer of the dermis in addition to the epidermis

A

Split thickness grass

84
Q

A surgical procedure to eliminate a scar contracture from a burn site

A

Z-plasty

85
Q

Caused by Bacterial infections including streptococci or staphylococci? Risk factors include immunosuppression, trauma, and venous insufficiency

A

Cellulitis - treated with systemic antibiotics

86
Q

A superficial irritation of the skin resulting from localized irritation IE poison ivy latex soap jewelry sensitivity

A

Contact dermatitis

87
Q

Contact Dermatitis signs and symptoms

A

Intense itching burning and Redskin in areas corresponding to the location of topical irritation edema me also be present in the area of sensitivity and symptoms. Treatment should focus on identifying and removing the source of irritation and then topical steroid application is commonly employed

88
Q

Loss of vascular supply causing local tissue death that most often occurs in fingers, toes, and limbs

A

Dry gangrene

Typically not painful

89
Q

What condition results as a complication of an untreated wound and occurs when there is an associated bacterial infection of the affected tissue?

A

Wet gangrene

Cessation of blood flow, occluded white blood cells thus they can’t fight the infection

90
Q

Fungal infection primarily affecting the toe nails and nail beds

A

Onychomycosis

91
Q

Chronic autoimmune disease of the skin occurring when the T cells trigger inflammation within the skin and produce accelerated rate of skin cell growth

A

Plaque psoriasis

Occurs bilaterally- red raised blotches

92
Q

Disease also known as athletes foot, superficial fungal infection which causes of piper all thickening and scaly skin appearance.

A

Tinea pedis

93
Q

Many inherited metabolic disorders will produce symptoms in a newborn including (8)

A

Lethargy, apnea, poor feeding, tachypnea, vomiting, hypoglycemia, urine changes, and seizures

94
Q

This condition is an autosomal recessive syndrome that consists of mental retardation as well as behavioral and cognitive issues secondary to elevation of serum phenylalanine.

A

Phenylketonuria

95
Q

An autosomal recessive disorder with an absence or deficiency of hexosaminidase A. This produces am accumulation of ganglioside a within the brain causing deterioration of motor and cognitive skills.

A

Tay-Sachs disease

Will die by age of 5

Mental retardation and paralysis

96
Q

Nausea, diarrhea, prolonged vomiting, confusion, muscle fasciculations, muscle cramping, neuromuscular hyperexcitability, convulsions, paresthesias, and hypoventilation. These are signs and symptoms of what disorder?

A

Metabolic alkalosis

97
Q

Hyperventilation vomiting diarrhea headache weakness and malaise hyperkalemia and cardiac arrhythmias. These are signs and symptoms of what condition?

A

Metabolic acidosis

98
Q

A metabolic bone disease where the bones become soft secondary to calcium or phosphorus deficiency. There is adequate bone matrix however there is insufficient calcification of the matrix due to the deficiency

A

Osteomalacia

Vitamin d deficiency will also cause osteomalacia

99
Q

Aching fatigue weigh loss, thoracic kyphosis, Boeing of the lower extremities or signs and symptoms of what condition

A

Osteomalacia

100
Q

Metabolic bone disease primarily affecting trabecular and cortical bone where the rate of bone resorption accelerates while the rate of bone formation declines

A

Osteoporosis

101
Q

Metabolic bone disease characterized by heightened osteoclastic activity. Bone appears to be enlarged but lacks strength due to the high turnover of bone secondary to the abnormal osteoclastic proliferation; typically occurs in patients over The age of 50

A

Paget’s disease

102
Q

A T or Z score of that is at or below -2.5 SD is indicative of

A

OP

If they also had one or more relative fractures the are considered to have severe OP

-1 to -2.5 SD means osteopenia

103
Q

5 key functions of the integ system

A 
Protection 
Vitamin d synthesis 
Thermoregulation 
Excretion of sweat 
Sensation

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